Local Government and Public Involvement in Health Bill

None of the questions that noble Lords ask is simple. I am sorry that the noble Baroness remembered the other question, although the first one was actually worse. Perhaps I may briefly go over the process. We think that giving local authorities the duty to establish LINks for procurement of hosts fits very well into the whole notion of devolution of power to local authorities in the Bill. It is right that this provision should be at local level and not delivered from a central body, which is exactly what we do not want to do. I have to resist for predictable reasons the proposal to put in the Bill a requirement on the Secretary of State to ensure that sufficient funds are available to cover the costs of a local authority and its work to put in place contractual arrangements to enable the establishment of LINk activities. As noble Lords know, the intention is that the Secretary of State will make a grant to each local authority to enable it to procure a host organisation to support the LINk and to fund its activities. Although the exact amount of these grants is still subject to the Comprehensive Spending Review—a mantra that is being echoed across all government departments—we have said that the total amount available for the new system of LINks should be equal to what is currently spent on patient forums. The noble Earl asked whether the amount of money will be comparable. The answer is yes. That will initially take the form of a three-year grant. It is not ring-fenced. There is nothing perverse in that. It is not ring-fenced because we have moved away from the ideology of ring-fencing. Indeed, the whole notion of local area agreements, to which we are moving in the Bill, is to have flexible pots that can enable services to support each other and draw on a much more coherent and explicit form of support. The funding will be explicitly targeted to ensure the purpose of making arrangements to establish a LINk. This will be visible; it will be discrete; and I am sure that it will be observed. In making the grant, the Secretary of State will assess what levels of funding will be necessary to cover the costs of each local authority. Obviously, this must be grounded in local realities. I hope that the noble Earl is reassured when I say that we are working with local authority representatives as well as with the Local Government Association to determine realistic budgets that will cover costs associated with administering and monitoring contracts. That will vary according to the nature of the area. Size is clearly a factor. Birmingham will have a very different set of requirements from those of a unitary authority such as Thurrock. The amendment of the noble Earl seems to present an irresistible argument, but I must resist it because, if I were to give in, it would be customary from here on to have a passage in every piece of legislation stating that funding would be sufficient. That then raises the question of who would be the statutory judge of whether the funds were sufficient. We are entering a minefield here. The Secretary of State will consider how much each local authority needs and will make a judgment as to the level of funds necessary, informed, as I have said, in these different ways about how the local authority can comply with its duty. The factors will be demographic—the nature of the population and the size of the area. I hope that that will meet the criteria of fairness, because it will certainly be a transparent process. We want LINks to work. We are not setting them up to fail. We want them to be as effective as possible. Proposed new subsection (4B) aims to allow local authorities to spend more on making contractual arrangements than the allocation provided for by the Secretary of State. That is a very important suggestion. Equally, it is very important that arrangements for LINks should allow for the possibility of additional funds being available from whatever sources exist. There is nothing in the Bill to prevent local authorities from making additional funds available for LINk activities. If, for example, they wanted to add to funding for LINks from their own engagement activities, I could see that there would be an argument. In the Bill, local authorities are under a duty to involve, inform and consult local people. If we can get some synergy, there may well be some possibilities. Amendment No. 238N is difficult to understand. It seems to take away a fundamental plank in the process of establishing a LINk; that is, the power for a local authority to make payments to a host. I am not sure whether I have missed something very important or subtle, but I cannot see any benefit in removing that provision because, as I have said, we think that it is vital that a host is created. Amendment No. 238QA seeks to ensure that the arrangements that the local authority makes with the host provide that the LINk has the necessary staff, premises and so on. This is a logical amendment in relation to the earlier one. I do not believe that it is necessary because I think that the whole point of the contractual arrangement, which we set out in the model contract, is precisely to state the types of support that the host is expected to give the LINk. It could be minimal, it could involve staff, support and premises, but it will vary. Every contract must reflect local realities. We are issuing a model contract specification. It is not mandatory but it is a guide to help tailoring in local circumstances. The local authority will be under a legal duty to make contractual arrangements with a host to ensure that LINks activities can be undertaken. The safeguard is there. On Amendment No. 238SA, the noble Baroness asked whether it will be possible for LINks to employ their own staff and decide such issues as pay and so on. I can certainly give her an assurance that it will be possible, as the provisions already allow for a LINk to be any sort of body, including one that can employ its own staff. I am thinking of companies limited by guarantee or charities with employment status. A more difficult question is when. It is difficult to say, because in some instances the contract could be held by the host immediately, but it would be explicit from the start that the LINks would want to do the employment. It would be in the nature of the contract. There will be LINks organisations that will grow in confidence and that may feel a year or two into the scheme that it is right for them to take over the employment functions. The provision has to be as flexible as that. I cannot see a problem with that. I do not think that we would want to prescribe this. I shall look at the matter again and come back to the noble Baroness if I think that there are ambiguities.